Anthem Provider Network Manager I - Must Sit in CA - Remote or Anthem Office - PS14129 in Anaheim, California

Provider Network Manager I - Must Sit in CA - Remote or Anthem Office - PS14129

Location: California, United States

Field: Provider Network Management

Requisition #: PS14129

Post Date: Dec 06, 2018

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve atone of America's leading health benefits companies and a Fortune Top 50 Company.

Provider Network Manager I

Must sit in California

Develops the provider network through contract negotiations, relationship development, and servicing. Primary focus of this role is contracting and negotiating contract terms with physician groups and hospitals, and helping resolve provider operational issues. Typically works with less complex providers which may include, but are not limited to, professional providers, practice groups, small medical groups, providers in less competitive markets, and providers with greater familiarity with managed care concepts. Contracts tend to be more standard and afford less opportunity for customization. Fee schedules are fairly standardized with reimbursement models limited and well-defined. May participate in intradepartmental projects or smaller projects impacting multiple departments. Operates with general supervision, elevating unusual situations to management as required.

Primary duties may include, but are not limited to:

  • Solicits participation in the network and conducts re-contracting efforts as needed.

  • Serves as a communication link between providers and the company.

  • Conducts limited negotiations and drafts documents.

  • Assists in preparing financial projections as required.

  • Coordinates resolution of provider contractual/operational issues with supporting departments.

  • Requires a BA/BS degree and 2 years’ experience in contracting, provider relations, provider servicing

  • Or any combination of education and experience, which would provide an equivalent background.

  • Requires travel 20% statewide

  • Familiar with CA managed care provider market strongly preferred

  • Good written and verbal communication required

  • Quantitative skills for contracting and negotiation experience preferred

  • Physician group and/or hospital contracting experience preferred

  • Must sit in California

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.